Neurological Disorders Flashcards
What does the CNS compose of?
Brain
Spinal cord
What PNS consist of ? What is it then devided into ?
Cranial & spinal nerves
It is also divided into somatic and autonomic nervous systems then into para and sympathetic nervous system
What incases the brain. Skull yes but what’s the professional term for that ?
Cranium
The brain in divided into 4 main parts what are they ??
Cerebrum
Cerebellum
Diencephalon
🧠 stem
What helps both hemispheres communicate ?
C_______ C______
Corpus collosum
What produces autonomic movements and body’s posture ?
Basal ganglia
What does the front al lobe control ?
Personality
Abstract thinking
Memory
Initiation of motor activity
What does the parietal lobe control
Spatial awareness
Receiving and interpreting sensory neurons
What does the temporal lobe control ?
Processing language and understanding memory
What is the occipital lobe controlling ?
Visual stimuli interpretation
Why is the brain stem also known as the reticular activating system
As it maintains wakefulness and consciousness
The midbrain (mesencephalon) is a short section of the brainstem stem which is between what 2 structures ?
Diencephalon and pons
It’s involved in the movement of eyes and the startle reflex !
The pons relay info between the cerebral hemispheres, transmit info from cerebellum to the brain stem, 5-8th cranial nerves run through the pons, and it also has another role in controlling what ?
Length and rate of respiration
Where does the medulla oblongata sit?
Just above the foremen magnum
Contained in the medulla oblongata there a number of reflex centres ?
Control what?
E.g sneezing (one of them)
Vomiting
Swallowing
Coughing
breathing
Heart rate
Blood vessel diameter
How much if the circulating volume of blood does the brain receive ?
10-20%
15-29%
20-25%
15-20% equiv: 800 mL of blood per min
What does the brain need a constant supply of?
Blood and glucose
How does the 🧠 get its blood supply ? Through what arteries
Vertebral arteries and internal carotid arteries
Which artery has pressoreceptors and Baroreceptors found in ?
These detect change in blood pressure
Internal carotid arteries
Vertebral artery
Internal carotid arteries
Chemoreceptors are found here too !
Chemoreceptors detect what?
change in the o2 levels and PH blood levels
The internal carotid and vertebral arteries connect to make what ? The _____ __ _____
Circle of Willis
The blood brain barrier has a function to ?
Filter between brain tissue and blood bourne substances to provide protection against harmful toxins and metabolites.
However not much protection from fat soluble molecules and respiratory gases that’s why
Anaesthetic gases, nicotine and alcohol have an effect on the brain
What specialised epithelial cells make CSF?
Choroid plexus
Where is CSF mainly found
Brains ventricles
How many vertebrae do humans have ?
33
What does the somatic nervous system consist of ? 💪
Motor neurons that connect the CNS to the skin and skeletal muscles 💪.
Regulation of skeletal muscle contraction
Occurs in the hemispheres above the tentorium cerebelli and has a specific dysfunction in a discrete area e.g numbness in hand.
I can get bigger and if I do ill effect consciousnesses of the human !
What lesion am I ?
Supratentorial lesion
Infratentorial lesion
Supretentorial lesion
What 3 areas can a small infratentorial lesion effect ?
Cardiovascular function
Respiratory function
Level of consciousness
Space occupying masses can compress what 2 things in the brain ?
Brain stem and (RAS) reticular activating system
RAS is the Coronal section of the pons, at its upper part.
Many systemic disorders like hypoglycaemia and acidosis can depress what system ? And result in what ?
CNS
PNS
ANS
SNS
CNS
Levels of conciousness to decrease
What would a reduced level of conciousness present like?
Lethargy
Confusion
Memory loss
Difficult to arouse
Unresponsive to verbal stimuli
Signs of terminal stage, deep coma ?
Loss of all reflexes
Fixed dilated pupils
Slow irregular pulse
Slow irregular respiration
Explain vegetative state …
Loss of awareness and mental capabilities resulting from diffuse brain damage although the 🧠 stem functions still work !
Supporting resp, cardio, and autonomic functions.
Pts will have significant neurological impairment !!
What is locked-in syndrome
Patient is aware and can think but is paralysed and cannot communicate.
What’ is hyperreflexia
overactive or overresponsive bodily reflexes. Examples of this include twitching and spastic tendencies, which indicate disease of the upper motor neurons and loss of control ordinarily exerted by higher brain centers of lower neural pathways (disinhibition).
Common causes focal brain lesions (typically causing unilateral hyperreflexia), cervical myelopathy, and motor neuron disease (amyotrophic lateral sclerosis, ALS). The latter is characterized by a combination of upper and lower motor neuron findings.
Spinal cord injury is the MAIN CAUSE!
Autonomic Hyperreflexia
Major symptoms include hypertension, headache, sweating, flushing or pallor above the level of the lesion, and bradycardia. Other less common signs include pupillary changes, Horner syndrome, nausea, and anxiety. The most common precipitants of autonomic hyperreflexia involve the urinary tract.
What does damage to the lower motor neurons in the spinal cord cause ?
Weakness or paralysis on the same side of the body and below the site of of injury
What is flaccid paralysis ?
Hint: absent
The reflexes are absent
Severe Damage to what part of the brain causes decorticate posturing ?
Cerebral hemispheres
Parietal lobe
Temporal lobe
Occipital lobe
Cerebral hemispheres
Decerabrate posturing is caused by what kind of damage to the 🧠?
Occurs With 🧠 stem lesions & CNS depression caused by systemic effects
Which lobe in the brain is the somatosensory cortex based in ?
Parietal lobe
What is fluent aphasia ? And where in the brain is the damage ?
Hint: aphasia is speech related
Pace of speech relatively normal but contains made up words / sentences that make no sense!
Damage to wernicke’s area
What’s non fluent aphasia ? And damage to which part of the brain ?
Slow laboured speech
Short phrases
Often small words are omitted
Broca area of 🧠
What’s dysarthia a damage to ?
Brain or cranial nerves
Cranial nerve damage or muscle impairement
Google:
where you have difficulty speaking because the muscles you use for speech are weak. It can be caused by conditions that damage your brain or nerves and some medicines.
What is dysarthia
difficulty speaking because the muscles you use for speech are weak
Agraphia is impaired… what
💡: task we do regularly
Writing ability
Alexia is impaired …….. ability
Reading 📕
What is agnosia?
Hint: we can have visual agnosia
Loss of recognition or association.
E.g visual agnosia: inability to recognize objects
Ptosis “droopy eyelid” which cranial nerve compression causes this?
Oculmotor so lll
What type of herniation displaces the cerebral hemispheres, diencephalon, midbrain. That effects the flow of blood & CSF, RAS and respirations
Transtentorial herniation
Uncal herniation
Cerebellar / tonsillar (intratentorial)
Transtentorial herniation
Which herniation causes a downward push towards the foreman magnum ? Compression of the brainstem and vital centers eventually causing death ?
Transtentorial herniation
Uncal herniation
Cerebellar / tonsillar (intratentorial)
Cerebellar / tonsillar (intratentorial)
Google:
Increased pressure in the posterior fossa forces the cerebellar tonsils through the foramen magnum. These will compress the lower part of the brain stem and upper cervical cord, resulting in life-threatening consequences.
What form the largest category of primary malignant tumours?
Gliomas: they’re from the glial cells which are paranchymal cells of the CNS systems
What kind of tumour do not have well-defined margins but are invasive and have irregular projections into adjacent tissue that make it more harder to remove ?
Astrocytes
Gliomas
Malignant tumours
Astrocytes
Why are some tumours considered “silent” in some areas ?
Because they grow without obvious signs so they grow large before their effects are noticeable !!
What are the most common tumours in children ?
Brainstem and cerebellar tumours
What tumours mostly affects adults ?
Tumours in the Cerebral hemisphere
What treatment is given to reduce cerebral odema ?
Glucocorticoids
How is meningococus spread ?
Droplets
What is the major cause of meningitis is elderly persons and young children ?
Pathogen found in a certain type of pneumonia
Streptococcus pneumoniae
Around how much CSF goes back into the the blood system after passing through the blood brain barrier ?
350MLs
name two different ways the pathogen causing meningitis enters the body?
Direct spread: entry if a pathogen not via the blood but through the skin.
Haemotogenous spread: pathogen entering via the blood.
What do the WBC release when the pathogen enters the blood ?
Cytokines
What’s the normal range of CSF?
7-25cm H20
7-18cm H20
7-20cm H20
7-15cm H20
7-18cm H20
When it rises to 20cm it’s also normal
When would you expect to see signs and symptoms of Meningitis ? What in the body would have to increase ?
Hint: 🧠
When the CSF increases and increases
How does meningitis causes CSF to increase?
Meningitis causes an imbalance between the water content of the brain parenchyma, CSF volume, and cerebral blood flow (CBF), resulting in an increase of ICP.
What does bacterial meningitis do to the glucose levels ?
Increase or decrease
Decrease
Explain the type of headache the pt will get with meningitis?
Thunderclap
Persistant & gradual
Tension
And will this type be relieved with paracetamol
Persistent & gradual
No it will not as it’s a result of raised ICP due to the inflammatory response.
Will the patient be pyrexic with meningitis ?
It can be mild or non existent so don’t be fooled
Just because they’re not pyrexic this doesn’t mean they don’t have meningitis
What is Nucal rigidity?
This is neck stiffness but itis mainly about stretching an already inflamed membrane
What is photophobia
This is loud noises that cause the pain to worsen
Symptoms for meningitis will not always have the classic symptoms listed so carefilll assessments should be done.
